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What Is Prediabetes?
Prediabetes means your blood glucose, or blood sugar, is higher than usual but not yet in the range used to diagnose diabetes. It can affect people with or without noticeable symptoms, especially those with certain inherited, health, or lifestyle-related risk factors. Prediabetes raises the chance of developing type 2 diabetes, but early action can often delay or prevent progression.
How It's Diagnosed
How Is Prediabetes Diagnosed?
Many people with prediabetes have no clear symptoms, so a healthcare professional usually identifies it with blood testing. Common tests include the A1C test, which reflects average blood glucose over time, fasting plasma glucose, and sometimes an oral glucose tolerance test. These results help show whether blood sugar is in the normal, prediabetes, or diabetes range.
| Category | A1C | Fasting glucose |
|---|---|---|
| Normal range | Below 5.7% | Below 100 mg/dL (5.6 mmol/L) |
| Prediabetes | 5.7%–6.4% | 100–125 mg/dL (5.6–6.9 mmol/L) |
| Diabetes | 6.5% or higher | 126 mg/dL (7.0 mmol/L) or higher |
A healthcare professional may repeat a test or order an additional test when results are borderline, unexpected, or need confirmation. An oral glucose tolerance test uses blood glucose measurements before and after drinking a glucose solution and may provide additional information. Only a healthcare professional can confirm a prediabetes diagnosis and explain what your results mean in context.
Causes
What Causes Prediabetes?
Prediabetes often develops when the body’s cells do not respond well to insulin, a hormone that helps glucose move from the bloodstream into cells. This insulin resistance allows more glucose to remain in the blood. The pancreas may initially produce extra insulin to compensate, but over time it may struggle to make enough insulin to keep blood sugar in the normal range.
Insulin resistance is the biological mechanism behind prediabetes, while risk factors affect how likely it is to develop. Inherited traits, body composition, physical activity, sleep, certain health conditions, and other factors can influence that likelihood. Having one or more risk factors does not guarantee that a person will develop prediabetes.
Risk Factors
Prediabetes Risk Factors
Non-modifiable factors
Risk may be higher with increasing age, a family history of type 2 diabetes, certain genetic or ethnic backgrounds, or a history of gestational diabetes. These factors cannot usually be changed, but they can help guide screening and prevention planning.
Modifiable factors
Physical inactivity, excess body weight when applicable, smoking, inadequate sleep, high blood pressure, and abnormal cholesterol may increase risk. Addressing these factors can support overall health, although no single change guarantees prevention.
- A history of cardiovascular disease may increase the likelihood of abnormal blood glucose.
- High blood pressure is associated with a higher risk of prediabetes.
- Abnormal cholesterol or triglyceride levels may contribute to metabolic risk.
- Polycystic ovary syndrome is associated with increased risk of insulin resistance and prediabetes.
- Risk assessment may differ according to age, ethnicity, family history, and other clinical factors.
Complications
Prediabetes Complications
The main concern is progression from prediabetes to type 2 diabetes. However, not everyone with prediabetes develops diabetes, and timely lifestyle changes and medical support may lower the risk. A healthcare professional can also assess related cardiovascular and metabolic risks.
- Prediabetes may progress to type 2 diabetes, although progression is not inevitable.
- Prediabetes may be associated with higher long-term cardiovascular disease risk.
- Blood pressure or cholesterol-related risk may worsen alongside metabolic changes.
- A clinician may identify other metabolic health concerns that need monitoring or treatment.
Treatment & Management
Prediabetes Treatment and Management
A Balanced Prediabetes Diet
A balanced prediabetes diet can include plenty of vegetables, high-fiber foods, minimally processed carbohydrates, protein, and portions that fit your needs. Limiting added sugars and highly processed foods may help support healthier blood glucose levels. A registered dietitian or structured diabetes prevention program can help adapt eating goals to your culture, preferences, budget, and health needs.
Regular physical activity, sustainable weight-related goals when appropriate, adequate sleep, and stopping smoking can support blood sugar management. Clinicians may monitor A1C or glucose over time and may discuss medication with selected people at higher risk. Medication is not a substitute for individualized medical advice or a complete prevention plan.
Prevention & Screening
Prediabetes Prevention and Screening
Prevention focuses on regular physical activity, nutritious eating, and appropriate weight-related goals when relevant. It also includes addressing blood pressure, cholesterol, smoking, and sleep concerns with professional support. These steps can improve overall health and may reduce the chance that prediabetes progresses to type 2 diabetes.
Who Should Ask About Screening?
Screening guidance
Ask when testing is right for you
Screening recommendations depend on age, risk factors, pregnancy history, and previous results. A healthcare professional can recommend the appropriate test and follow-up schedule.
Outlook and Prognosis
Outlook for Prediabetes
Prediabetes is not an inevitable progression to type 2 diabetes. Timely lifestyle changes and medical support can improve blood sugar and lower the chance of progression for many people. Some people may see their glucose return to a healthier range, while others may remain stable with ongoing management.
Risk depends on individual factors, including test results, family history, health conditions, and lifestyle. Continued testing and management remain important even when glucose levels improve because risk can change over time. Your healthcare professional can recommend an appropriate follow-up plan.
Next Steps After Diagnosis
Next Steps After a Prediabetes Diagnosis
- Review the test and result with a healthcare professional.
- Ask which risk factors should be addressed first.
- Create an individualized eating and activity plan.
- Ask whether a diabetes prevention program or dietitian referral would help.
- Confirm when follow-up blood testing is recommended.
